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https://www.readbyqxmd.com/read/28810115/current-guidelines-on-syncope
#1
Maheedhar Gedela, Naveen Rajpurohit, Kashif A Shaikh, Muhammad Omar, Scott Pham
Syncope is a very commonly encountered clinical problem in general practice and in the emergency department. In the evaluation of syncope, it is important to identify the specific cause to determine the treatment, to estimate the precise risk to a patient, and to reduce recurrence. Sometimes, making a diagnosis of syncope is difficult, as different mechanisms may often coexist. Syncope causes a significant impact on quality of life due to associated risk of physical injury. In particular, syncope can be a precursor to sudden cardiac death in patients with underlying cardiac disease...
November 2016: South Dakota Medicine: the Journal of the South Dakota State Medical Association
https://www.readbyqxmd.com/read/28808515/palpitations-as-a-presenting-feature-of-multisystem-sarcoidosis
#2
Richie Manikat, Julieta Gilson, Mahesh Krishnamurthy, Koroush Khalighi
Introduction: Sarcoidosis is described as a systemic condition characterized by non-caseating granulomas in multiple organs. In this report, we present an unusual manifestation of cardiac sarcoidosis and review management strategies. Case presentation: A 29-year-old African-American man presented with weight loss, fatigue, dyspnea, palpitations, night sweats, painless left eye redness and bilateral leg pain over the course of three months. His physical exam revealed left conjunctival congestion and bilateral crackles on auscultation...
July 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/28807079/syncope-during-competitive-events-interrogating-heart-rate-monitor-watches-may-be-useful
#3
Oscar Thabouillot, Kevin Bostanci, Francois Bouvier, Nicolae Dumitrescu, Maria Stéfuriac, Philippe Paule, Nicolas-Charles Roche
This is a case report of a 45-year-old man who reported complete amnesia during the very first kilometer of a 10-km run. He was wearing a heart rate monitor (HRM). The interrogation of his HRM watch showed 200 bpm tachycardia beginning in the first kilometer and increasing up to 220 bpm during the last kilometer. The patient was asked to wear a Holter-monitor (Holter Research Laboratory; Helena, Montana USA) electrocardiogram (ECG) while practicing a training session. This examination allowed for the diagnosis of an adrenergic paroxysmal atrial fibrillation (AF) with an impressive auriculo-ventricular conduction over 260 bpm...
August 15, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28804588/first-reported-case-of-arrhythmogenic-right-ventricular-cardiomyopathy-in-oman
#4
Hatim Al Lawati, Humoud Al Dhuhli
Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a rare genetic disorder characterized by fatty degeneration of the right ventricular myocardium with variable involvement of the left ventricle. The condition is associated with exercise-mediated ventricular tachycardia and is one of the recognized causes of sudden cardiac death in the young and in athletes. Here, we report the first confirmed case of ARVC in Oman and present its electrocardiographic, echocardiographic features, and radiological findings on gated, contrast-enhanced cardiac computed tomography...
July 2017: Oman Medical Journal
https://www.readbyqxmd.com/read/28802656/rethinking-papillary-muscle-resection-for-refractory-ventricular-tachycardia-in-the-lvad-era-a-case-report
#5
Zachary J Il'Giovine, Adam D DeVore, Chetan B Patel, Jason Koontz, Jacob Schroder
We report the case of a 57-year-old man with a history of ischemic cardiomyopathy who presented to the hospital with recurrent episodes of ventricular tachycardia refractory to antiarrhythmic medications. Mapping identified a deep premature ventricular contraction focus in the anterolateral papillary muscle, an area that has been previously identified as difficult to treat with radiofrequency catheter ablation. The hospital course was complicated by cardiogenic shock and VT-storm, and the patient ultimately underwent surgical resection of the anterolateral papillary muscle with left ventricular assist device placement as a successful bridge to cardiac transplantation...
July 12, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28801137/the-challenges-of-treating-recurrent-polymorphic-ventricular-tachycardia-due-to-coronary-vasospasm-lessons-from-an-interesting-case
#6
Naveen Trehan, Mobeen Ur Rehman, Anupama Kottam
Coronary artery vasospasm can cause recurrent anginal episodes with ST-segment elevation. Vasospasm induced myocardial ischemia can lead to arrhythmias including life threatening ventricular tachycardia (VT). Percutaneous coronary intervention (PCI), although not routinely recommended for treating vasospastic angina, can be considered for discrete coronary spasm that is not amenable to vasodilator therapy. We present a challenging case of a 41-year-old lady with recurrent episodes of vasospastic angina and VT refractory to medical therapy, which was successfully treated with PCI and an implantable cardioverter defibrillator...
July 12, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28800178/outcomes-of-catheter-ablation-of-ventricular-tachycardia-with-mechanical-hemodynamic-support-an-analysis-of-the-medicare-database
#7
Arash Aryana, André d'Avila, Christina L Cool, Marc A Miller, Fermin C Garcia, Gregory E Supple, Srinivas R Dukkipati, Dhanunjaya Lakkireddy, T Jared Bunch, Mark R Bowers, Padraig Gearoid O'Neill, Vivek Y Reddy, Francis E Marchlinski
INTRODUCTION: There is a paucity of data in favor of mechanical support during catheter ablation of ventricular tachycardia (VT). This study investigated the outcomes of VT ablation associated with mechanical support using percutaneous ventricular assist device (PVAD) versus intra-aortic balloon pump (IABP). METHODS AND RESULTS: We retrospectively examined the outcomes of patients who underwent VT ablation associated with PVAD versus IABP from 2010-2013, captured by the Medicare Inpatient Standard Analytic File database...
August 11, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28798020/unipolar-endocardial-voltage-mapping-in-the-right-ventricle-optimal-cutoff-values-correcting-for-computed-tomography-derived-epicardial-fat-thickness-and-their-clinical-value-for-substrate-delineation
#8
Jeroen Venlet, Sebastiaan R D Piers, Gijsbert F L Kapel, Marta de Riva, Philippe F G Pauli, Rob J van der Geest, Katja Zeppenfeld
BACKGROUND: Low endocardial unipolar voltage (UV) at sites with normal bipolar voltage (BV) may indicate epicardial scar. Currently applied UV cutoff values are based on studies that lacked epicardial fat information. This study aimed to define endocardial UV cutoff values using computed tomography-derived fat information and to analyze their clinical value for right ventricular substrate delineation. METHODS AND RESULTS: Thirty-three patients (50±14 years; 79% men) underwent combined endocardial-epicardial right ventricular electroanatomical mapping and ablation of right ventricular scar-related ventricular tachycardia with computed tomographic image integration, including computed tomography-derived fat thickness...
August 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28797351/implant-and-midterm-outcomes-of-the-subcutaneous-implantable-cardioverter-defibrillator-registry-the-effortless-study
#9
Lucas Boersma, Craig Barr, Reinoud Knops, Dominic Theuns, Lars Eckardt, Petr Neuzil, Marcoen Scholten, Margaret Hood, Juergen Kuschyk, Paul Jones, Elizabeth Duffy, Michael Husby, Kenneth Stein, Pier D Lambiase
BACKGROUND: The subcutaneous implantable cardioverter-defibrillator (S-ICD) was developed to defibrillate ventricular arrhythmias, avoiding drawbacks of transvenous leads. The global EFFORTLESS S-ICD (Evaluation oF FactORs ImpacTing CLinical Outcome and Cost EffectiveneSS of the S-ICD) registry is collecting outcomes in 985 patients during a 5-year follow-up. OBJECTIVES: The primary goal of the EFFORTLESS registry is to determine the safety of the S-ICD by evaluating complications and inappropriate shock rate...
August 15, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28794139/denervated-myocardium-is-preferentially-associated-with-sudden-cardiac-arrest-in-ischemic-cardiomyopathy-a-pilot-competing-risks-analysis-of-cause-specific-mortality
#10
James A Fallavollita, Jonathan D Dare, Randolph L Carter, Sunil Baldwa, John M Canty
BACKGROUND: Previous studies have identified multiple risk factors that are associated with total cardiac mortality. Nevertheless, identifying specific factors that distinguish patients at risk of arrhythmic death versus heart failure could better target patients likely to benefit from implantable cardiac defibrillators, which have no impact on nonsudden cardiac death. METHODS AND RESULTS: We performed a pilot competing risks analysis of the National Institutes of Health-sponsored PAREPET trial (Prediction of Arrhythmic Events with Positron Emission Tomography)...
August 2017: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28794111/clinical-characteristics-and-long-term-outcome-of-hypertrophic-cardiomyopathy-in-individuals-with-a-mybpc3-myosin-binding-protein-c-founder-mutation
#11
Hannah G van Velzen, Arend F L Schinkel, Rogier A Oldenburg, Marjon A van Slegtenhorst, Ingrid M E Frohn-Mulder, Jolanda van der Velden, Michelle Michels
BACKGROUND: MYBPC3 (Myosin-binding protein C) founder mutations account for 35% of hypertrophic cardiomyopathy (HCM) cases in the Netherlands. We compared clinical characteristics and outcome of MYBPC3 founder mutation (FG+) HCM with nonfounder genotype-positive (G+) and genotype-negative (G-) HCM. METHODS AND RESULTS: The study included 680 subjects: 271 FG+ carriers, 132 G+ probands with HCM, and 277 G- probands with HCM. FG+ carriers included 134 FG+ probands with HCM, 54 FG+ relatives diagnosed with HCM after family screening, 74 FG+/phenotype-negative relatives, and 9 with noncompaction or dilated cardiomyopathy...
August 2017: Circulation. Cardiovascular Genetics
https://www.readbyqxmd.com/read/28789916/flecainide-reduces-ventricular-arrhythmias-in-patients-with-genotype-ryr2-positive-catecholaminergic-polymorphic-ventricular-tachycardia
#12
Fernando Wangüemert Pérez, Julio Salvador Hernández Afonso, María Del Val Groba Marco, Eduardo Caballero Dorta, Luis Álvarez Acosta, Oscar Campuzano Larrea, Guillermo Pérez, Josep Brugada Terradellas, Ramón Brugada Terradellas
INTRODUCTION AND OBJECTIVES: Catecholaminergic polymorphic ventricular tachycardia (CPVT) is an inherited disease characterized by polymorphic or bidirectional ventricular arrhythmias (VA) triggered by physical or emotional stress in young people with a structurally normal heart. Beta-blockers are the cornerstone of treatment, while flecainide has recently been incorporated into the therapeutic arsenal. The aim of this study was to report our experience with this drug. METHODS: The cohort included 174 genotype-positive CPVT-patients from 7 families...
August 5, 2017: Revista Española de Cardiología
https://www.readbyqxmd.com/read/28781852/electrical-storm-in-the-inflamed-heart-ventricular-tachycardia-due-to-myocarditis
#13
Gustav Mattsson, Peter Magnusson
Electrical storm during the acute inflammatory phase caused by myocarditis may be resistant to antiarrhythmic therapy. Cardiac imaging including magnetic resonance tomography, positron emission tomography, and endomyocardial biopsy are crucial to guide potential therapeutic options. Optimal management involves a multidisciplinary approach, including expertise beyond cardiology.
August 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/28775185/frequency-of-exercise-induced-st-t-segment-deviations-and-cardiac-arrhythmias-in-recreational-endurance-athletes-during-a-marathon-race-results-of-the-prospective-observational-berlin-beat-of-running-study
#14
Juliane Herm, Agnieszka Töpper, Alexander Wutzler, Claudia Kunze, Matthias Krüll, Lars Brechtel, Jürgen Lock, Jochen B Fiebach, Peter U Heuschmann, Wilhelm Haverkamp, Matthias Endres, Gerhard Jan Jungehulsing, Karl Georg Haeusler
OBJECTIVES: While regular physical exercise has many health benefits, strenuous physical exercise may have a negative impact on cardiac function. The 'Berlin Beat of Running' study focused on feasibility and diagnostic value of continuous ECG monitoring in recreational endurance athletes during a marathon race. We hypothesised that cardiac arrhythmias and especially atrial fibrillation are frequently found in a cohort of recreational endurance athletes. The main secondary hypothesis was that pathological laboratory findings in these athletes are (in part) associated with cardiac arrhythmias...
August 3, 2017: BMJ Open
https://www.readbyqxmd.com/read/28775062/de-novo-fgf12-fibroblast-growth-factor-12-functional-variation-is-potentially-associated-with-idiopathic-ventricular-tachycardia
#15
Qianqian Li, Yuanyuan Zhao, Gang Wu, Shanshan Chen, Yingchao Zhou, Sisi Li, Mengchen Zhou, Qian Fan, Jielin Pu, Kui Hong, Xiang Cheng, Qing Kenneth Wang, Xin Tu
BACKGROUND: Idiopathic ventricular tachycardia (VT) is a type of cardiac arrhythmia occurring in structurally normal hearts. The heritability of idiopathic VT remains to be clarified, and numerous genetic factors responsible for development of idiopathic VT are as yet unclear. Variations in FGF12 (fibroblast growth factor 12), which is expressed in the human ventricle and modulates the cardiac Na(+) channel NaV1.5, may play an important role in the genetic pathogenesis of VT. METHODS AND RESULTS: We tested the hypothesis that genetic variations in FGF12 are associated with VT in 2 independent Chinese cohorts and resequenced all the exons and exon-intron boundaries and the 5' and 3' untranslated regions of FGF12 in 320 unrelated participants with idiopathic VT...
August 3, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28774644/preincision-initiation-of-dexmedetomidine-maximally-reduces-the-risk-of-junctional-ectopic-tachycardia-in-children-undergoing-ventricular-septal-defect-repairs
#16
Nischal K Gautam, Yuliya Turiy, Chandra Srinivasan
OBJECTIVE: To evaluate whether initiation of dexmedetomidine (DEX) infusion before surgical incision and cardiopulmonary bypass (CPB) versus initiation after CPB had an impact on the incidence of junctional ectopic tachycardia (JET). DESIGN: Retrospective cohort study. SETTING: Single tertiary-care cardiac center. PARTICIPANTS: Children undergoing cardiopulmonary bypass for repair of congenital heart disease involving ventricular septal defects between January 2010 and February 2013...
April 10, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28771538/a-novel-noninvasive-surface-ecg-analysis-using-interlead-qrs-dispersion-in-arrhythmogenic-right-ventricular-cardiomyopathy
#17
Wan-Hsin Hsieh, Chin-Yu Lin, Abigail Louise D Te, Men-Tzung Lo, Cheng-I Wu, Fa-Po Chung, Yi-Chung Chang, Shih-Lin Chang, Chen Lin, Li-Wei Lo, Yu-Feng Hu, Jo-Nan Liao, Yun-Yu Chen, Shih-Jie Jhuo, Sunu Budhi Raharjo, Yenn-Jiang Lin, Shih-Ann Chen
BACKGROUND: This study investigated the feasibility of using the precordial surface ECG lead interlead QRS dispersion (IQRSD) in the identification of abnormal ventricular substrate in arrhythmogenic right ventricular cardiomyopathy (ARVC). METHODS: Seventy-one consecutive patients were enrolled and reclassified into 4 groups: definite ARVC with epicardial ablation (Group 1), ARVC with ventricular tachycardia (VT, Group 2), idiopathic right ventricular outflow tract VT without ARVC (Group 3), and controls without VT (Group 4)...
2017: PloS One
https://www.readbyqxmd.com/read/28770457/exercise-induced-polymorphic-ventricular-tachycardia-during-treadmill-stress-test
#18
Federico G De Puy, Ayman A Farag, Vineet Kumar
No abstract text is available yet for this article.
August 2, 2017: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/28770255/massive-accumulation-of-myofibroblasts-in%C3%A2-the-critical-isthmus-is-associated-with%C3%A2-ventricular-tachycardia-inducibility-in%C3%A2-post-infarct-swine-heart
#19
Tarvinder S Dhanjal, Nicolas Lellouche, Christopher J von Ruhland, Guillaume Abehsira, David H Edwards, Jean-Luc Dubois-Randé, Konstantinos Moschonas, Emmanuel Teiger, Alan J Williams, Christopher H George
OBJECTIVES: In this study the authors determined the extent of cellular infiltration and dispersion, and regional vascularization in electrophysiologically (EP) defined zones in post-myocardial infarction (MI) swine ventricle. BACKGROUND: The critical isthmus (CI) in post-MI re-entrant ventricular tachycardia (VT) is a target for catheter ablation. In vitro evidence suggests that myofibroblasts (MFB) within the scar border zone (BZ) may increase the susceptibility to slow conduction and VT, but whether this occurs in vivo remains unproven...
July 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/28767385/left-anterior-descending-coronary-artery-dissection-during-ventricular-tachycardia-ablation-case-report
#20
Kordic Kresimir, Manola Sime, Zeljkovic Ivan, Benko Ivica, Pavlovic Nikola
Fascicular left ventricular tachycardia (VT) is the second most frequent idiopathic left VT in the setting of a structurally normal heart. Catheter ablation is curative in most patients with low complication rates. We report a case of ostial left anterior descending coronary artery (LAD) occlusion during fascicular ventricular tachycardia ablation. Dissection was the most likely cause of LAD obstruction. To the authors' best knowledge, this is the first case reporting selective LAD dissection during electrophysiology study with no left main coronary artery (LMCA) affection...
July 26, 2017: Romanian Journal of Internal Medicine, Revue Roumaine de Médecine Interne
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